Assuntos
Neoplasias Retais/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Colectomia , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radioterapia Adjuvante , Neoplasias Retais/diagnóstico , Neoplasias Retais/mortalidade , Estudos Retrospectivos , Taxa de SobrevidaAssuntos
Neoplasias Colorretais/cirurgia , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/patologia , Feminino , Humanos , Masculino , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Complicações Pós-Operatórias/mortalidade , Rhode Island , Taxa de SobrevidaRESUMO
A malignancy rate of 24% was achieved as a result of needle localizations and biopsies of 548 nonpalpable mammographically detected breast lesions in 507 consecutive patients during a 5-year period. Malignancy was present in 74 (23.8%) of 311 irregular soft-tissue densities, in 40 (19.6%) of 204 cases with clustered microcalcifications, and in 33 cases (54.5%) when both features were present. Same-day admission and discharge were achieved in 491 patients and local anesthesia supplemented with intravenous sedation was used in 73 (74%) of the 98 patients (in 1989) by the end of the study period. Nonpalpable cancers were categorized pathologically as stage 0 in 25 patients (20.8%), stage I in 67 patients (55.8%), stage IIA in 24 patients (20.0%), and stage IIB in four patients (3.3%). The malignancy rate rose sharply from the fourth to the fifth decade.
Assuntos
Neoplasias da Mama/epidemiologia , Mama/patologia , Carcinoma Intraductal não Infiltrante/epidemiologia , Mamografia , Biópsia por Agulha/métodos , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Carcinoma Intraductal não Infiltrante/diagnóstico por imagem , Carcinoma Intraductal não Infiltrante/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Palpação , Estudos Retrospectivos , Fatores de TempoAssuntos
Aneurisma/etiologia , Artrite Reumatoide/complicações , Doenças da Coluna Vertebral/complicações , Artéria Vertebral , Aneurisma/cirurgia , Angiografia , Artrite Reumatoide/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço/diagnóstico por imagem , Doenças da Coluna Vertebral/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Artéria Vertebral/diagnóstico por imagemRESUMO
The EEA stapling instrument was used to perform 48 anastomoses without operative mortality. One of the 29 colorectal anastomoses developed a leak. Two intraabdominal abscesses were noted, one after an intraperitoneal colocolostomy and one after a colorectal anastomosis. No leaks were demonstrated in the 12 esophageal anastomoses. Minor bleeding that occurred in one of the colorectal anastomoses ceased spontaneously without need for transfusion. One esophageal and one colorectal anastomosis became narrowed postoperatively, but both were corrected with dilatation without further problem. In two of the very low colorectal anastomoses, transient fecal soilage occurred for 4 to 5 months postoperatively. On the basis of our experience, we believe that the EEA instruments has a definite place in gastrointestinal surgery. Its greatest virtue is that it provides a means to perform the heretofore technically difficult and frequently insecure colorectal and esophageal anastomoses with greater facility and security.
Assuntos
Colo/cirurgia , Reto/cirurgia , Grampeadores Cirúrgicos/normas , Duodeno/cirurgia , Esôfago/cirurgia , Humanos , Íleo/cirurgia , Piloro/cirurgia , Estômago/cirurgia , Técnicas de SuturaRESUMO
Three hundred fifty-seven groin hernia repairs were performed under local anesthesia using a long-lasting local anesthetic agent. An ilioinguinal, iliohypogastric, and twelfth intercostal nerve block was carried out initially, followed by regional infiltration of the agent, using a technic first described by Ponka [8] with several modifications. This technic can be employed suffessfully in the majority of groin hernia repairs. It requires careful attention to detail in the administration of preoperative sedation and analgesia and the use of sharp dissection only and greater gentleness in the handling of tissue. We have observed a significant reduction in postoperative discomfort and the virtual elimination of urinary retention, urinary sepsis, atelectasis, and phlebitis in these cases. All patients are fully ambulatory, without assistance immediately after surgery and the majority are discharged the same day or the following morning. This results in a marked reduction in the total cost of repairing a groin hernia.